Deck 4 COPY COPY COPY Flashcards
why do myxomas create inflammation
bc they release IL-6
what types of fluids does someone in septic shock need
crystalloid so either saline or crystalloid
what abx do you use for C diff infection
vanc or fidaxomicin and if its severe you add IV metro
relationship of trachea to esophagus
trachea is anterior to the esophagus
does damage to the pancreas cause acute hemodynamic changes
no
if there is no blood in the FAST exam where is the blood likely if a pt is unstable
likely the pelvis
signs of inhalation injury
Prolonged smoke exposure in an enclosed space, Facial burns, Wheezing, nasopharyngeal blistering
what does a aortic dissection look like from the CT angio
there is an intimal flap where you have hte disscetion in the lumen
signs of graves opthomology
Lid lag, proptosis, diplopia
pain worsened by passive dorsiflexion of big toe dx
plantar faciitis
pathophys of hyperparathyroidism in chronic kidney diseaseq
chronic stimulation causes hyperplasia of the parathyroid causing secretion even in the setting of elevated calcium
A-a gradient in atelectasis
elevated
management of auricular hematoma
immediate drainage
what is a hypopneon
purulent haziness and layering of leukocytes over the conjunctivae
presentation of acute mesenteric ischemia
rapid onset periumbilical pain, hematochezia, pain out of proportion to exam findings
seminoma hormone elevations
only bHCG
mixed germ cell tumor hormone elevations
AFP and BHCG
leydig cell tumor hormone elevations
estrodiol is high
pseudoanerysm vs. AV fistula bruit
pseudoaneurysm is only systolic and AV fistula is continuous
can you still actively plantar flex with achilles tendon rupture
yes, bc of collateral connections from other muscles and tendons
signs of osteoarthritis on xray
loss of joint space, periarticular osteophytes, sclerosis of the acetabular surface
xray signs of chronic osteomyelitis
ragged fracture, fragmentation of the bone
chronic wound drainage post surgical fixation of long bone dx
chronic osteomyelitis
what is tophous gout
slowly enlarging hard mass in people with gout due to bursal infiltration of gout crystals
penile injury initial management
if evidence of urethral injury then they need retrograde urethrography
intraperitoneal fluid bladder injury location
bladder dome
retroperitoneal fluid bladder injury location
anterior wall of bladder
what is the troussou sign
migrating thrombophlebitis (red itchy stretch marks)
what is the troussou sign typicall associated with
most often pancreatic cancer, but can be others
do you need to do genetic testing for hereditary spherocytosis
nope you can just do splenectomy after blood smear
signs of non hemolytic transfusion reaction
fever, chills, mild shortness of breath, myalgias, nausea, etc
cause of non hemolytic transfusion reaction
preformed antibodies to donor leukocytes
treatment of methemeglobinemia
methylene blue
treatment of carbon dioxide poisoning
hyperbaric O2 chambre
pathophys of cushings reflex
rising intracranial pressures occlude vessels which decreases perfusion so MAP increases to allow for increased perfusion to the brain, causing very high BP, bradycardia and irregular respirations
slow growing pinkish skin lesion
likely basal cell CA
management of septic arthritis
IV ABX and I&D
cardiogenic shock SVR
increased because CO is decreased
first line medication in treatment of aortic dissection
labetolol to lower BP and HR
management of PAD
first smoking cessation and exercise therapy, then meds, then surgery
what indicates the severity of aspiration pneumonia
volume of aspirated fluid
signs of cholangiocarcinoma
RUQ pain, weight loss, nausea, vomiting, fevers, signs of bile duct obstructin
dx of cholangiocarcinoma
ERCP so that you can visualize the CBD
what type of bilirubinemia in a cholangioCA
direct bc it is a blockage so its overflowing
etiology of zenker diverticulum
cricopharyngeal muscle spasm
what type of thyroid cancer is familial typcially
medullary
which patients get pituitary adenoma vs. craniopharyngioma
pit adenoma - adults // craniopharyngioma - kids
rotator cuff inflammation signs
pain with abduction and external rotation, normal ROM with impingement signs
when do you perform surgical debridement after burns
> 72 hours after
when to cath someone for burns
immediately so you can monitor their urine output
how does CMV manifest as reactivation
typically it is a colitis
severe complication of IBD
toxic megacolon
treatment of toxic megacolon from IBD
steroids
signs of toxic megacolon on xray
loss of haustra, large dilated colon, air fluid levels
most common cause of nosocomial blood stream infection
central venous catheters
BCC or melanoma of the face exicsion technique
Mohs
likely etiology of vomiting post Roux-en-Y bypass
anastamotic stenosis
clinical clues for renovascular causes of HTN
recurrent flash pulmonary edema, malignant HTN, uncontrolled HTN despite multiple meds
K+
values in renovascular disease
activated RAAS causes elevated aldosterone which causes low potassium
expanding neck hematoma management
immediate wound exploration to decompress hematoma
massive transfusion protocol blood products
FFP, packed RBCs, platelets
AC joint sprain clinical clue
pain with adduction of the arm across torso
pathophys of gallstones for a patient on TPN
gallbladder stasis
next step for patients that cant tolerate anticoagulation for lower extremity DVT
IVC filter
best way to maintain output function of a patient with hypertrophic cardiomyopathy
hemodynamic stability (give fluids)
which type of echo is best
TEE
posterior urethral injury presentation
blood at urethral meatus, high riding prostate
next stp in management of posterior urethral injury
retrograde urethrogram
low T3/euthyroid sick syndrome etiology
high circulating glucocorticoids and inflammatory cytokines cause decreased conversion of T4 –> T3
dx of gallstone pancreatitis
RUQ ultrasound
